RANGE OF MOTION AFTER BONE BLOCK PROCEDURES FOR SHOULDER INSTABILITY: SYSTEMATIC REVIEW.

Objective: to determine the surgical indications for glenoid bone grafting associated with better postoperative ranges of motion. Methods: This systematic review was conducted according to PRISMA. The included studies were subdivided according to the criteria used to indicate glenoid bone graft surgery: group for radiological indications only (Group R), group for radiological indications associated with clinical indications (Group R + C), and group for arthroscopic indications (Group A). The extracted and evaluated data were the range of motion of the shoulder. Results: in the electronic search conducted in October 2022, 1567 articles were selected. After applying the inclusion criteria, 14 articles were selected for the systematic review. Regarding the ranges of motion, group A had the highest number of statistically positive results together with group R. Group A showed positive results in elevation parameters, loss of lateral rotation in adduction, and medial rotation in abduction. Group R showed positive results in lateral rotation in adduction and loss of lateral rotation in adduction. On the other hand, Group R + C was the one that presented the highest number of statistically negative results, in the following parameters: elevation, lateral rotation in abduction, loss of lateral rotation in adduction, and medial rotation in abduction. Conclusion: the subgroups presented variable results in the evaluated parameters; however, the groups with arthroscopic and radiological indications showed the highest number of positive results, with the latter group showing the best results regarding lateral rotation. Level of Evidence II, Systematic Reviews.

Objetivo: Determinar as indicações cirúrgicas de enxertia óssea da glenoide associadas aos melhores arcos de movimento no pós-operatório. Métodos: De acordo com o Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 14 artigos de um total de 1.567, selecionados em busca eletrônica, foram escolhidos para a revisão sistemática. Os estudos incluídos foram subdivididos de acordo com os critérios de indicação da cirurgia: indicações somente radiológicas (grupo R), indicações radiológicas associadas a indicações clínicas (grupo R + C) e indicações artroscópicas (grupo A). Os dados avaliados foram os arcos de movimento do ombro. Resultados: Em relação aos arcos de movimento, os grupos que apresentaram a maior quantidade de resultados estatisticamente positivos foram o A ­ parâmetros elevação, perda de rotação lateral em adução e rotação medial em abdução ­ e o R ­ parâmetros rotação lateral em adução e perda de rotação lateral em adução. O grupo R + C apresentou a maior quantidade de resultados estatisticamente negativos nos parâmetros elevação, rotação lateral em abdução, perda de rotação lateral em adução e rotação medial em abdução. Conclusão: Os grupos de indicações artroscópicas e radiológicas apresentaram a maior quantidade de resultados positivos, sendo que o último apresentou os melhores resultados em relação à rotação lateral. Nível de Evidência II, Revisão Sistemática.

Anticonvulsant activity of Tetrahydrolinalool: behavioral, electrophysiological, and molecular docking approaches.

Tetrahydrolinalool (THL) is an acyclic monoterpene alcohol, produced during linalol metabolism and also a constituent of essential oils. As described in the literature, many monoterpenes present anticonvulsant properties, and thus we became interested in evaluating the anticonvulsant activity of Tetrahydrolinalool using in mice model as well as in silico approaches. Our results demonstrated that THL increased latency to seizure onset and also reduced the mortality, in picrotoxin induced seizure tests. The results may be related to GABAergic regulation, which was also suggested in seizure testing induced by 3-mercapto-propionic acid. In the strychnine-induced seizure testing, none of the groups pretreated with THL modulated the parameters indicative of anticonvulsant effect. The electrophysiological results revealed that THL treatment reduces seizures induced by pentylenetetrazole. The in silico molecular docking studies showed that the interaction between THL and a GABAA receptor model formed a stable complex, in comparison to the crystaligraphic structure of diazepam, a structurally related ligand. In conclusion, all the evidences showed that THL presents effective anticonvulsant activity related to the GABAergic pathway, being a candidate for treatment of epileptic syndromes.

Anabolic steroids and the evaluation of patients with acute PM tendon rupture using microscopy and MRI.

This study presented a pioneering investigation of the changes in the magnetic resonance imaging images of pectoralis major muscle (PMM) tendon rupture. In all, 26 men were evaluated with acute total PMM rupture (<3 months since injury) with a mean age of 37.3 years (SD = 9.7 years) and 10 control patients with a mean age of 32.6 years (SD = 4.2 years). The evaluation of the tendon PMM injuries was based on the magnetic resonance imaging exam and the histological analysis. The magnetic resonance imaging of the surgically showed two (7.1%) contralateral sides were normal, 16 (57.1%) showed superior tendinopathy, and 10 (35.7%) had total tendinopathy. Inferior tendinopathy was not observed. The tendon histology revealed degenerative changes in 16 (66.7%) fragments, with 12 (50.0%) considered as mild (<25%), and four considered as (16.7%) high (>50.0%) tendinopathy. Total acute rupture of the PMM tendon among weightlifters might be associated with tendinous degeneration prior to injury.

Exploring the role of ChatGPT in clinical decision-making in otorhinolaryngology: a ChatGPT designed study.

PURPOSE: Since the beginning of 2023, ChatGPT emerged as a hot topic in healthcare research. The potential to be a valuable tool in clinical practice is compelling, particularly in improving clinical decision support by helping physicians to make clinical decisions based on the best medical knowledge available. We aim to investigate ChatGPT's ability to identify, diagnose and manage patients with otorhinolaryngology-related symptoms. METHODS: A prospective, cross-sectional study was designed based on an idea suggested by ChatGPT to assess the level of agreement between ChatGPT and five otorhinolaryngologists (ENTs) in 20 reality-inspired clinical cases. The clinical cases were presented to the chatbot on two different occasions (ChatGPT-1 and ChatGPT-2) to assess its temporal stability. RESULTS: The mean score of ChatGPT-1 was 4.4 (SD 1.2; min 1, max 5) and of ChatGPT-2 was 4.15 (SD 1.3; min 1, max 5), while the ENTs mean score was 4.91 (SD 0.3; min 3, max 5). The Mann-Whitney U test revealed a statistically significant difference (p < 0.001) between both ChatGPT's and the ENTs's score. ChatGPT-1 and ChatGPT-2 gave different answers in five occasions. CONCLUSIONS: Artificial intelligence will be an important instrument in clinical decision-making in the near future and ChatGPT is the most promising chatbot so far. Despite needing further development to be used with safety, there is room for improvement and potential to aid otorhinolaryngology residents and specialists in making the most correct decision for the patient.

First Report of Metadelphax propinqua (Fieber) (Hemiptera: Delphacidae) Feeding on Bermudagrass in Brazil.

Bermudagrass (Cynodon dactylon (L.) Pers., Poaceae) is one of the most important pasture grasses used in milk production systems in southern Brazil, with an increasing expansion of cultivated areas in recent years. Here, we report the first occurrence of the planthopper Metadelphax propinqua (Fieber) (Hemiptera: Delphacidae) feeding on bermudagrass in Brazil. Population outbreaks of this species were observed in January/February 2023 in a commercial hay production farm in the municipality of Chapecó, Santa Catarina State, southern Brazil. Metadelphax propinqua was found in association with three cultivars of C. dactylon (Tifton 85, Jiggs, and Vaquero). The infested plants showed leaf chlorosis and a reduced plant growth rate due to sap sucking and toxin injection as well as honeydew deposition on the leaves, which led to the development of sooty mold. In addition, this delphacid species has been reported as a vector of important pathogens to bermudagrass species and other row crops. Thus, M. propinqua is a potential pest of bermudagrass in Brazil and should be monitored to assess its establishment and behavior in Brazilian pasturelands.

Shoulder injuries in Brazilian professional football players: epidemiological analysis of 3828 games.

OBJECTIVES: Football is a globally played sport that poses potential risks for musculoskeletal injuries. Upper-limb injuries have a lower incidence rate than lower-limb injuries but can still cause absenteeism and performance impairment in football players. This descriptive epidemiological study aimed to evaluate and compare the epidemiological data on shoulder injuries among professional football players in two major Brazilian football championships. METHODS: Data were collected throughout the championships, and club physicians medically evaluated each player during official games using two online forms. The collected information included the player's age and position, injury diagnosis, laterality, location on the field where the injury occurred, playing time, imaging examinations performed, need for surgical treatment, time to return to play (TRP), and recurrence of the injury. The incidence of injuries was evaluated using the Federation Internationale de Football Association (FIFA) incidence formula. RESULTS: A total of 107 shoulder injuries were recorded (4.3% of all injuries), with a FIFA incidence of 0.847. Glenohumeral dislocations (GHDs) and acromioclavicular dislocations (ACDs) accounted for 37.38% and 35.51% of all shoulder injuries, respectively. Goalkeepers and defenders presented, respectively, a 2.15 and 1.57 times increased risk of suffering shoulder injuries, while attackers presented a 0.63 times decreased risk. Injury recurrence was observed in 14.95% of cases, with GHDs and ACDs showing recurrence rates of 35.00% and 5.26%, respectively. Surgery was performed in 9.35% of cases, with GHDs representing 50% of all surgeries. The average TRP was 22.37 days, with severe and major injuries accounting for 11.21% and 10.28% of all injuries, respectively. Goalkeepers had the highest average TRP of 36.15 days. Recurring injuries had a higher average TRP of 33.44 days compared to nonrecurring injuries, which had an average TRP of 20.43 days. Surgically treated injuries had the highest average TRP of 112.5 days. CONCLUSION: Shoulder injuries in the professional football scenario are of great concern due to the high recurrence rate and need for surgical treatment, which will lead to a long TRP. These findings emphasize the need to implement prevention protocols and effective treatments to reduce the consequences of such injuries, which are usually underestimated in this sport. LEVEL OF EVIDENCE: III.

Effects of mixtures of arrestants, dislodgers, and phagostimulants with synthetic insecticides on green-belly stink bug: walking behavior assessments, physicochemical interactions, and laboratory and field trials.

The green-belly stink bug (Diceraeus melacanthus Dallas (Hemiptera: Pentatomidae)) is a key pest of corn-soybean crop systems and the management of this pest is difficult due to behavioral characteristics. However, products that alter its behavior, such as arrestants, dislodgers, and phagostimulants, have been used in an attempt to improve the effectiveness of chemical control. In this study, the effect of these products on the walking behavior of nymphs and adults of D. melacanthus was initially evaluated through computational behavioral tracking (Ethovision system). Adults of D. melacanthus exposed to the dislodgers Creolin Pearson and Quimifol S450 (sulfur) significantly increased the distance covered and the walking speed. On the other hand, the only treatment that significantly affected the walking behavior of nymphs was the treatment with soy milk (phagostimulant). The physical-chemical analyses indicated considerable changes in the pH and electrical conductivity of mixtures of such products with insecticides from different chemical groups, as well as lack of homogeneity (physical incompatibility). Nevertheless, none of the products tested improved the control efficacy of an insecticide based on imidacloprid + beta-cyfluthrin, either in laboratory tests (contact bioassay) or in tests conducted in corn crops during 2 crop harvests. Thus, the association of these products in a tank mixture does not increase the control levels of D. melacanthus in post-emergence of maize and may have an antagonistic effect in some associations.

Necrosis of the Tongue as a Late Complication of Radiotherapy.

Introduction: Irradiation to treat head and neck cancer, causing chronic tissue damage, is associated with the development of vascular disease. Interest has risen over the effects of radiotherapy on major vessels, due to its high morbidity and mortality rate. However, small-vessel disease has been poorly studied and described. Case Report: We present a case of a patient with bilateral necrosis of the anterior third of the tongue, occurring 3 years after chemoradiotherapy treatment for squamous cell carcinoma of the floor of the mouth. Contrast-enhanced CT scan showed multiple areas of stenosis concerning both external carotid arteries and their branches, and total opacification of lingual arteries. Conservative management was performed, with auto-amputation on the fifth day, which allowed healing by secondary intention. Conclusions: Necrosis of the tongue appears as a rare late complication of radiotherapy, possibly due to its acceleration effect on the atherosclerosis process. Following small-vessel disease, one can assume a higher potential risk of major-vessel disease, highlighting the importance of a routine assessment and prophylaxis of thrombotic events.

ASSESSMENT OF THE LEVEL OF SATISFACTION OF PATIENTS SUBMITTED TO LATARJET SURGERY UNDER OUTFIT SYSTEM COMPARED TO HOSPITAL SYSTEM.

Anterior shoulder instability causes functional changes that affect patients' quality of life. The Latarjet procedure is one of the most frequently performed surgeries for cases of recurrent shoulder instability. Objective: To assess the level of satisfaction of patients who underwent the Latarjet procedure in outpatient settings (day hospital) compared with inpatient settings. Methods: A questionnaire was administered to both groups and a descriptive analysis of the results was performed. Results: 51 patients were included, with a mean age of 29.9 years, 82.3% men and 17.6% women. Of the patients who underwent surgery in the day hospital, 46.1% were operated within 100 days of their first outpatient visit; among those in the inpatient group, 76.3% underwent surgery more than 200 days later. Delays occurred in 15.3% of cases in the day hospital compared with 68.4% in the inpatient group. Of the patients in the day hospital, 92.3% felt comfortable contacting the medical team in case of complications and would perform the procedure again in the same setting. Moreover, 63.2% of inpatients would have preferred to have been discharged on the same day. The final satisfaction rate for both groups was 100%. Conclusion: Outpatient surgery guarantees more patient comfort, safety, and can be performed in a timely manner and with fewer delays, which has influenced patients' decision to have surgery during the COVID-19 pandemic. Level of Evidence V, Cross-sectional Study.

A instabilidade anterior do ombro acarreta alterações funcionais que impactam a qualidade de vida do paciente. A cirurgia de Latarjet é um dos procedimentos mais executados para casos de instabilidade recorrente de ombro. Objetivo: Comparar o grau de satisfação dos pacientes submetidos ao procedimento de Latarjet no regime ambulatorial (hospital dia) com o dos operados no regime hospitalar. Métodos: Um questionário foi aplicado em ambos os grupos e uma análise descritiva dos resultados foi realizada. Resultados: Foram incluídos 51 pacientes, com idade média de 29,9 anos, sendo 82,3% homens e 17,6% mulheres. Dos submetidos à cirurgia no hospital dia, 46,1% operaram em até 100 dias depois do primeiro atendimento ambulatorial; já entre os do grupo hospitalar, 76,3% operaram mais de 200 dias depois. O atraso na cirurgia ocorreu com 15,3% dos pacientes do hospital dia contra 68,4% do grupo hospitalar. Do hospital dia, 92,3% pacientes sentiram-se confortáveis em contatar a equipe médica em caso de intercorrências e fariam novamente o procedimento de forma ambulatorial. Além disso, 63,2% dos internados gostariam de ter recebido alta no mesmo dia. O grau de satisfação final em ambos os grupos foi de 100%. Conclusão: A cirurgia ambulatorial garante mais conforto para o paciente, mostrando-se segura e podendo ser performada em tempo hábil e com menos atrasos, o que influenciou a decisão dos pacientes em operar durante a pandemia de COVID-19. Nível de Evidência V, Estudo Transversal.

Association of growth-regulating insecticides and limonoid-based formulations: physicochemical compatibility and toxicity against Spodoptera frugiperda (Lepidoptera: Noctuidae).

The objective of this study was to evaluate the physicochemical compatibility of mixtures of synthetic and botanical limonoid-based insecticides, as well as the toxicity of these associations, in the management of Spodoptera frugiperda (J.E. Smith) under laboratory and field conditions. For this, the associations of 4 commercial botanical insecticides based on neem registered in Brazil (Azamax, Agroneem, Azact CE, and Fitoneem) were tested with synthetic insecticides from the group of growth regulators (IGRs [triflumuron, lufenuron, methoxyfenozide and tebufenozide]). When mixed, all combinations caused a significant reduction in the pH of the mixture and a significant increase in electrical conductivity. However, all tested combinations showed similar stability behavior to the negative control (distilled water), which demonstrated their physicochemical compatibility. Furthermore, in laboratory and field bioassays, mixtures of IRGs with limonoid-based formulations provided satisfactory effects in the management of S. frugiperda. However, binary mixtures of insecticide Intrepid 240 SC with Azamax or Azact CE (at LC25 previously estimated) showed the highest toxicities on S. frugiperda larvae in laboratory bioassays and damage reduction caused by S. frugiperda in a 2-yr field experiments. Therefore, mixtures of IGRs with limonoid-based botanical insecticides are promising alternatives for the management of S. frugiperda and important component of integrated pest management and insect resistance management programs.

Evaluation of imazalil dissipation/migration in postharvest papaya using low-temperature partition extraction and GC-MS analysis.

Methods involving solid-liquid extraction with low-temperature partition and analysis by gas chromatography coupled to mass spectrometry (GC-MS) were validated to investigate the dissipation/migration of residues of the postharvest fungicide imazalil in papaya skin, pulp, and seeds. The fruits were stored for 23 days (14 °C). Every two days, fruits from the control group and those treated with imazalil had their skin, outer pulp, inner pulp, and seeds separated and then analyzed by GC-MS. After the 23rd day, about 70% of the imazalil had dissipated. Most of the remaining residue was found in the skin; however, the small amount migrating into the pulp was above the maximum residue levels allowed by the regulatory agencies. Imazalil residue was also detected in seeds at concentrations lower than the LOQ (0.025 mg kg-1). Mass loss was the only quality parameter that showed a significant difference between the fruits of the control and study groups.

Predictive factors of revision endoscopic sinus surgery.

PURPOSE: Despite endoscopic sinus surgery (ESS) being the standard best treatment for chronic rhinosinusitis with nasal polyps (CRSwNP), there still remains a high recurrence rate of nasal polyps after ESS. The aim of this study was to analyze the impact of ESS in the treatment of CRSwNP and identify possible predictors for revision surgery. METHODS: We conducted a cross-sectional retrospective study of patients with CRSwNP submitted to ESS between the years 2013 and 2021. RESULTS: We analyzed 517 cases, of which 15.1% were submitted to revision ESS. The presence of hyposmia/anosmia, asthma, intolerance/allergy to non-steroid inflammatory drugs, non-steroidal anti-inflammatory drug exacerbated respiratory disease, and bilateral polyposis were more frequent in patients who needed revision surgery. Initial values of peripheral eosinophilia and Lund-Mackay scores were significantly higher in this sub-group of patients. Lund-Mackay score was the only independent risk factor for revision surgery. CONCLUSIONS: Factors like peripheral eosinophilia and Lund-Mackay score were associated with a higher probability of revision ESS. Applying these concepts to the clinical practice could help predict the evolution of patient's pathology in the post-operative period and identify in advance those cases that may need a multidisciplinary approach.

Sublethal effects of growth-regulating insecticides of synthetic and botanical origins on the biological parameters of Spodoptera frugiperda (Lepidoptera: Noctuidae).

The objective of this study was to evaluate the effects of growth-regulating insecticides of synthetic (e.g., Certero 480 SC, Intrepid 240 SC, Match EC and Mimic 240 SC) and botanical origins (e.g., Azamax 1.2 EC, Agroneem 850 EC, Azact 2.4 EC and Fitoneem 850 EC) on the biological parameters and fertility life table of Spodoptera frugiperda (J.E. Smith) under laboratory conditions. Larvae were fed insecticides that were incorporated into artificial diets. To develop the fertility life table, the following biological parameters were evaluated: survival at 7 days after infestation (d.a.i) and survivorship at adult eclosion, duration of the neonate-to-adult eclosion period, larval and pupal weights and total fecundity (number of total eggs per female). The results indicated that S. frugiperda neonates surviving LC25 or LC50 concentrations of the evaluated insecticides showed longer larval and egg-to-adult periods, lower larval and pupal weights and reduced fecundity, when compared to the control treatment. Larvae exposed to Azamax at LC25 or LC50 concentrations showed the greatest increase in generation duration (75 d). In addition, S. frugiperda adults emerged from pupae when larvae reared on an artificial diet containing growth regulating insecticides of synthetic and botanical origins produced fewer females per female per generation (Ro). As well as, lower rates of natural population increase per day (rm) compared to insects fed the control diet. Our findings indicated that, neem-derived products and growth-regulating insecticides of synthetic origin may be employed within integrated management strategies that aim to keep populations of S. frugiperda below levels that cause economic damage. Similarly, they offer alternatives for insecticide resistance management programs.

Assessment of the level of satisfaction of patients submitted to latarjet surgery under outfit system compared to hospital system / Avaliação do grau de satisfação do paciente submetido à cirurgia de latarjet em regime ambulatorial em comparação com o regime hospitalar

ABSTRACT Anterior shoulder instability causes functional changes that affect patients' quality of life. The Latarjet procedure is one of the most frequently performed surgeries for cases of recurrent shoulder instability. Objective: To assess the level of satisfaction of patients who underwent the Latarjet procedure in outpatient settings (day hospital) compared with inpatient settings. Methods: A questionnaire was administered to both groups and a descriptive analysis of the results was performed. Results: 51 patients were included, with a mean age of 29.9 years, 82.3% men and 17.6% women. Of the patients who underwent surgery in the day hospital, 46.1% were operated within 100 days of their first outpatient visit; among those in the inpatient group, 76.3% underwent surgery more than 200 days later. Delays occurred in 15.3% of cases in the day hospital compared with 68.4% in the inpatient group. Of the patients in the day hospital, 92.3% felt comfortable contacting the medical team in case of complications and would perform the procedure again in the same setting. Moreover, 63.2% of inpatients would have preferred to have been discharged on the same day. The final satisfaction rate for both groups was 100%. Conclusion: Outpatient surgery guarantees more patient comfort, safety, and can be performed in a timely manner and with fewer delays, which has influenced patients' decision to have surgery during the COVID-19 pandemic. Level of Evidence V, Cross-sectional Study.

RESUMO A instabilidade anterior do ombro acarreta alterações funcionais que impactam a qualidade de vida do paciente. A cirurgia de Latarjet é um dos procedimentos mais executados para casos de instabilidade recorrente de ombro. Objetivo: Comparar o grau de satisfação dos pacientes submetidos ao procedimento de Latarjet no regime ambulatorial (hospital dia) com o dos operados no regime hospitalar. Métodos: Um questionário foi aplicado em ambos os grupos e uma análise descritiva dos resultados foi realizada. Resultados: Foram incluídos 51 pacientes, com idade média de 29,9 anos, sendo 82,3% homens e 17,6% mulheres. Dos submetidos à cirurgia no hospital dia, 46,1% operaram em até 100 dias depois do primeiro atendimento ambulatorial; já entre os do grupo hospitalar, 76,3% operaram mais de 200 dias depois. O atraso na cirurgia ocorreu com 15,3% dos pacientes do hospital dia contra 68,4% do grupo hospitalar. Do hospital dia, 92,3% pacientes sentiram-se confortáveis em contatar a equipe médica em caso de intercorrências e fariam novamente o procedimento de forma ambulatorial. Além disso, 63,2% dos internados gostariam de ter recebido alta no mesmo dia. O grau de satisfação final em ambos os grupos foi de 100%. Conclusão: A cirurgia ambulatorial garante mais conforto para o paciente, mostrando-se segura e podendo ser performada em tempo hábil e com menos atrasos, o que influenciou a decisão dos pacientes em operar durante a pandemia de COVID-19. Nível de Evidência V, Estudo Transversal.

Rupture of the bilateral and simultaneous tendon of the pectoralis major muscle. Description of three cases.

Pectoralis major muscle tendon ruptures associated with physical activity or effort are no longer uncommon in the medical literature. Treatment has also evolved significantly in the last 20 years. However, simultaneous bilateral rupture has only been described in a few cases. This article reports three cases with simultaneous bilateral rupture and describes the examinations and treatment performed. Bilateral lesions, although infrequent, also require early diagnosis and treatment in the acute phase. The chronic phase requires tendon grafting for full correction and a slow rehabilitation process.

Epidemiology of Upper Limb Injuries in two major Brazilian Soccer Championships from 2016 to 2019.

PURPOSE: To evaluate epidemiological data of upper limb injuries in professional athletes who participated in two major Brazilian soccer championships between 2016 and 2019. METHODS: A prospective cohort study was conducted to evaluate the teams of two divisions over four seasons within the Brazilian Soccer Championship and the Paulista Soccer Championship. Clubs and their doctors were contacted to participate in the study and guided on the correct way to enter data via online platforms: Transfermarkt (Transfermarkt GmbH & Co. KG) and Survey Monkey (Momentive.AI). Demographic data, injury characteristics, and FIFA Incidence Formula were analyzed. RESULTS: Overall, the study analyzed 3,828 matches and 126,357 hours of play. Upper limb injuries were registered 169 times, representing 6.8% of total injuries, with a FIFA incidence of 1.34. Most lesions occurred in forward players (21.3%), the shoulder exhibited the highest number of injuries (63.3%). The player's position was related to the location on the field where the injury occurred (p < 0.001); however, there was no relationship between the type of injury and the location on the body (p > 0.001). The average time to return to play was 19.1 days (range 0-200 days) and it was longer for goalkeepers. The necessity of surgical treatment was statistically associated with additional time to return to play (p < 0.001). CONCLUSIONS: Shoulder injuries were the most frequent upper limb injury sustained during the two major Brazilian soccer championships. Forward players suffered the most upper limb injuries and goalkeepers experienced the longest time to return to play.

What is the best position for coracoid fixation in the Latarjet procedure?

Hypothesis: Multiple problems and complications associated with Latarjet fixation have been described; thus, this is the first study in the literature to identify the maximum allowed screw clamping force and best fixation screw position for Latarjet surgery. Methods: A variation of distal and proximal coracoid screw positions with and without a flat washer was evaluated through finite element analysis, at a minimum distance of 3 mm from the edge. A loading progression test was performed until the maximum stress reached a limit imposed by the bone yield. We identified the maximum allowed screw clamping force based on a von Mises and maximum principal stresses failure theory. Results: When using the flat washer, the cortical bone generally has only space for 1 piece. For this reason, as a primary study, it was observed that when the distal screw was more than 7 mm from the edge, the clamping force supported will be higher than that during the proximal fixation regardless of the proximal location screw. We have found that the best position is 7 mm from the distal edge, with the highest compression of 445 N (7 mm proximal distance, 5 mm distal distance) in due respect to the von Mises failure theory. To get around this lack of space situation, in this study, we have proposed a fixation plate to replace the flat washer. This plate has shown very interesting values when compared to the previously flat washer study, but now, for both screw holes. With those results, we can assure that using a fixation plate like this will ensure surgery safety and higher allowed compression force when clamping the bolts. Conclusion: The distal screw provided higher tensile strength values when located more than 7 mm from the coracoid edge. The geometry of the coracoid in its distal position supports higher stress loads than in the proximal position. When the flat washer was in the proximal position, the coracoid was submitted with a more distributed and uniform load, preventing localized bone damage as a crush.

Deois flexuosa (Hemiptera: Cercopidae) in Perennial Forage Species (Poaceae): Quali-quantitative Impacts and Tolerance Expression.

This study aimed to characterize the quantitative and qualitative damage caused by Deois flexuosa (Walker) (Hemiptera: Cercopidae) adults in Axonopus catharinensis cv. SCS 315 Catarina and Cynodon dactylon (Tifton 85 and Jiggs cultivars) under different infestation densities and, consequently, the expression of tolerance-type resistance. For this purpose, potted plants were infested with different insect densities (0, 5, 10, 20, and 40 adults m-2). The impact of the infestation levels was assessed in the first growth cycle (10-day coexistence period) and in the regrowth (40 days after the first cut, without infestation) based on crop yield and chemical-bromatological composition as well as on photosynthetic pigments and hydrogen peroxide content. The principal component analysis relating infestation density and chemical-bromatological parameters showed a positive correlation between infestation density of D. flexuosa and the contents of neutral detergent fiber, acid detergent fiber, and the dry matter (DM). On the other hand, infestation density inversely correlated with the tillering rate, photosynthetic pigments (chlorophyll a and b, carotenoids), and iron content. In general, the impacts on DM production and chemical-bromatological composition were lower in A. catharinensis cv. SCS 315 Catarina when compared to the Cynodon species, possibly because A. catharinensis has higher tillering capacity and does not show a reduction in the photosynthetic pigments, which may act as compensating factors to D. flexuosa damage. Our results demonstrate that the A. catharinensis cultivar expresses tolerance-type resistance to D. flexuosa and constitutes an interesting option for pasturelands formation and diversification where this spittlebug species is an emerging pest.

Evaluation of Latarjet procedure in female athletes: a 3-year follow-up prospective cohort study.

Background: Although there is a low incidence of shoulder instability in women, this population is still representative and is often associated with lower rates of return to sports. Few studies have evaluated the results of the Latarjet procedure in this population. Methods: This was a prospective cohort study of female athletes who underwent the Latarjet procedure between 2013 and 2018. The participants were followed up for 3 years. The primary outcomes of the study included the visual analog scale for pain; range of motion: active elevation, passive elevation, active external rotation, and passive external rotation. The functional scores were as follows: American Shoulder and Elbow Surgeons score, the Western Ontario Shoulder Instability Index, and the Athletic Shoulder Outcome Rating Scale. Additional data were collected regarding return to sport, complication rates, and patient satisfaction. Results: Thirteen female athletes who practice Soccer, Volleyball, Basketball, Handball, Judo, or Weight training were evaluated. There was a significant reduction in the mean range of motion for all movements at 4 weeks after surgery. Patients recovered a range of motion similar to the preoperative values after 6 months. The mean visual analog scale reached 6.39 at the first week after surgery and decreased to values below preop at 8 weeks. The mean preoperative Western Ontario Shoulder Instability Index was 126.77 (min 118; max 135), and at the end of follow-up, the WOSI index was 45.08 (min 37; max 65; P < .05). The mean preoperative American Shoulder and Elbow Surgeons score was 41.61 (min 35; max 46), and at the end of follow-up, the mean ASES score was 84.46 (min 80; max 90; P < .05). The mean Athletic Shoulder Outcome Rating Scale in the preoperative period was 39.38 (min 37; max 42), and at the end of follow-up, the mean ASORS score was 83.15 (min 77; max 85; P < .05). The rate of return to sports was 92.3%, and 84.6% of patients were satisfied with the surgery. The aesthetic satisfaction rate was 76.9%. The complication rate was 15.4% (1 screw failure and 1 dislocation recurrence). Conclusion: Latarjet surgery in female athletes showed high rates of return to sports and improved functional scores without impairing range of motion after the procedure. Recurrence and complication rates were low. In addition, treatment was associated with improved functionality and patient satisfaction.

Anticonvulsant Activity of trans-Anethole in Mice.

Epilepsy is a chronic neurological disorder affecting 1-2% of world population, and one-third of patients are refractory to pharmacological treatment. This fact has stimulated research for new antiepileptic drugs and natural products have been an important source. trans-Anethole (TAN) is a phenylpropanoid, component of some essential oils, extracted from plants, and its effects have been little studied. Therefore, this study is aimed at investigating the TAN effect in classic seizure models and evaluate the electroencephalographic (EEG) profile of animals treated with this substance. For this, Swiss male mice (Mus musculus) were used, and the lethal dose was evaluated and subsequently submitted to the test maximal electroshock (MES), the pentylenetetrazole- (PTZ) induced seizure test, and the EEG profile. Initially, the LD50 for TAN was estimated in 1000 mg/kg (i.p.) dose and there was no sign of acute toxicity or death. In the MES test, TAN 300, i.p. (12.00 ± 2.9 s) and 400 mg/kg, i.p. (9.00 ± 4.4 s) doses was able to decrease tonic seizures duration induced by electric discharge (0.5 mA, 150 pulses/s, for 0.5 s). In the PTZ test (75 mg/kg, i.p.), TAN 400 mg/kg, i.p. increased the latency to myoclonic jerks (80.0 (56.0-134.0)), the latency totonic-clonic seizures (900.0 (861.0-900.0) and decrease seizure duration (0.0 (0.0-10.0)). No deaths were found in this groups compared to vehicle. EEG analysis showed an amplitude decrease of waves (ratio of baseline) in TAN 300 (1.82 ± 0.23) and 400 mg/kg (1.06 ± 0.16) groups. In this way, TAN at 400 mg/kg was able to inhibit and/or attenuate seizures by increasing the time for the onset of spasms and convulsions, as reducing the duration of seizures. The EEG profile corroborate with this results showing a reduction in the amplitude of waves compared to the PTZ group. Thus, TAN showed an anticonvulsant effect in all experimental models performed, behavioral and electroencephalographic.